Americans suffering from depression are increasingly turning to ketamine for treatment, but concerns are growing about how people get their hands on the controversial drug.

Ketamine has been used in hospitals to anesthetize humans for decades. The Food and Drug Administration (FDA) approves it for use on humans and animals. Famous in party circles, the drug is called "Special K," and it is known to produce an out-of-body hallucinogenic high.

Now the Wall Street Journal reports that psychiatrists are growing concerned about the number of people purchasing off-label ketamine online in unregulated digital marketplaces. Recent studies have shown ketamine has a positive effect on people suffering from severe depression and can be used as a treatment when other drugs have proven non-effective, but generic ketamine isn't approved for those conditions.

Johnson & Johnson created a chemically similar drug called esketamine in 2019 for treatment-resistant depression and to be used by adults with major depression who are experiencing suicidal thoughts. The FDA approved the drug, administered through nasal spray by the name Spravato, but it is only available at certified doctor's offices and clinics because of its potential misuse. After administration, patients must be monitored for 2 hours.

Online ketamine sellers do not offer the same type of oversight.

A simple Google search will find multiple online retailers offering ketamine to be picked up at your nearest pharmacy or by mail after a virtual consultation with one of their clinicians. Prices among online retailers and pharmacies vary with one offering a four-month subscription and treatment plan that costs up to $2,999.

ClearSpring Pharmacy recommends finding a clinic that administers Spravato, but the site recommends a compound pharmacy if a patient requires a different dosage.

"We are able to provide a dosage size that may not be available commercially," the ClearSpring Pharmacy website states. "If the patient is not a great risk for addiction, they may also take their compounded ketamine in the comfort of their own home."

Dr. Benjamin Yudkoff, medical director of the ketamine and esketamine program at Brigham and Women's Faulkner Hospital in Boston, said online ketamine prescriptions and taking the drug from home can be hazardous to the patient.

"Places that are doing virtual ketamine are negotiating a compromise between accessibility and safety," Yudkoff told the Journal.

Ketamine can cause slowed breathing as well an increase in heart rate and blood pressure. It can also be addictive if taken too often and in high quantities.

While virtual retailers advise users to take the drug with someone else present and instruct patients to follow a list of instructions, the environment cannot be regulated. The risk of malpractice is high, said Dr. Michael Champeau, president of the American Society of Anesthesiologists.

"Giving any drug like that has the potential to cause general anesthesia at home in a completely unmonitored environment," Champeau told the Journal.